A long-term care program that was a long time in coming to Northeastern Wisconsin might be drastically altered before it's had a chance to work here.

Under Gov. Scott Walker's 2015-17 budget proposal, the Family Care program would be cut by $14 million and its structure would be altered.

Family Care helps older adults and people with disabilities with daily tasks as well as managing chronic conditions, often allowing them to stay in their homes instead of moving to a care facility.

The program was available in 57 of the 72 counties in Wisconsin until the governor announced on April 21 that it would expanded to seven counties in Northeastern Wisconsin — Brown, Kewaunee, Door, Shawano, Menominee, Oconto and Marinette.

It hinged on approval by the Joint Finance Committee, which it finally received in November. Seven months later.

Family Care has helped reduce the state Medicaid budget and by expanding it to all 72 counties, it would allow 1,600 people on waiting lists to get services and save the state $34.7 million over 10 years, according to a state Department of Health Services report.

The report said: "Managed long-term care is the most effective strategy to meet the needs of Wisconsin's residents."

Plus, it lets people receive care in a setting that best suits them, whether it's their own home or an assisted-living facility. Care in nursing homes and institutions are more expensive.

Critics are worried about for-profit groups taking over and reducing the options for participants. At a Joint Finance Committee meeting Wednesday in Brillion, Patricia Finder-Stone of De Pere expressed that concern. "Family Care gives seniors independence and choices about the services and support that's available to meet their specific needs. … These groups — most likely insurance companies — have a business model, which encourages the denial of services in order to minimize costs."

The state has said the changes will help prevent fraud and abuse and will coordinate care better, bringing acute and primary health care services under the Family Care umbrella.

Yet the state is hazy about how the self-directed care would work, and that has us worried, because by all accounts, the program works.

Family Care and IRIS, which helps adults with personal care, serve about 50,000 state residents, but this is an issue that affects not only those 50,000 people, but their family members as well.

It's an issue that should concern us all because it's not a question of fiscal expediency we're talking about. It's an extreme policy change. Plus, it's a question of how we as a society should help our elderly citizens and people with physical and intellectual disabilities.